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Ultrasonography in Sternoclavicular Joint Posterior Dislocation in an Adolescent - A Case Report

  • Noh, Young Min;Jeon, Seung Hyub;Yoon, Hyung Moon
    • Clinics in Shoulder and Elbow
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    • v.17 no.4
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    • pp.205-208
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    • 2014
  • Sternoclavicular joint posterior dislocations are considered a very uncommon, and type of injury where if esophagus or airway injury occurs behind the clavicle, it poses a high risk to the patient. In addition, if epiphyseal fracture occurs as a result of the sternoclavicular joint posterior dislocation, surgical treatment is often required. However, in the absence of a complete ossification of the clavicle, it is difficult to differentiate between a simple dislocation and epiphyseal fracture-dislocation solely based on simple radiographs or computed tomography scans. In this case report, the authors present a case in which a sternoclavicular joint posterior dislocation was diagnosed in a 14-year-old male athlete. The case report discusses how the posterior dislocation without epiphyseal fracture was diagnosed using an ultrasound and subsequently treated with successful outcomes using manual reduction. The case report presents our findings along with discussion that includes a literature review of relevant research.

Cytologic Diagnosis of Metastatic Hepatocellular Carcinoma by Aspiration Cytology of Sacrum (천골의 세침흡인검사로 진단된 전이성 간세포암종)

  • Shim, Jung-Weon;Ko, Ill-Hyang
    • The Korean Journal of Cytopathology
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    • v.1 no.2
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    • pp.179-184
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    • 1990
  • Bone metastasis of hepatocellular carcinoma appears to be peculiar when clinical manifestation of liver disease is not apparent, and initial diagnosis of metastatic hepatocellular carcinoma by fine needle aspiration cytology is rarely obtained. We experienced a case of 45-year-old man with metastatic hepatocellular carcinoma in the sacrum, which was diagnosed by fine needle aspiration cytology. The intrahepatic mass, measuring 1.2 cm in diameter and kept unchanged in size for two years, was never proved to be hepatocellular carcinoma histopathologically. The aspirated neoplastic cells were mostly in sheets, showing abundant acidophilic cytoplasm and large, round, centrally located nuclei with single, prominent acidophilic mucleoli. In the cell block section, diagnosis of metastatic well-differentiated hepatocellular carcinoma was made without difficulty, and definite trabecular fashion with sinusoidal endothelial cell lining was found.

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RELATIONSHIP BETWEEN TEST-ANXIETY, DEPRESSION, TRAIT ANXIETY AND STATE ANXIETY (시험불안과 우울, 특성불안 및 상태불안과의 상호관계에 관한 연구)

  • Jung, Yeoung;Hong, Kang-E;Shin, Min-Sup;Seong, Yeong-Hoon;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.225-236
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    • 2001
  • Introduction:Test anxiety is a pervasive problem among high school students in Korea. While anxiety in test situations may actually facilitate the performance of some students, more often it is disruptive and leads to performance decrements. Over the past years, many child psychiatrists have become concerned with understanding the nature of test anxiety, but it is not clearly understood yet. In order to understand the nature of test anxiety, the relationship between test anxiety and depression, state anxiety, trait anxiety was examined. In addition, the relationships between the subscores of test anxiety (worry and emotionality) and the subscores of CDI, state anxiety or trait anxiety were examined. Methods:The Test Anxiety Inventory, Chidlren's Depression Inventory, State-Trait Anxiety Inventory were administered to 425 high school students in Seoul. The relationships between test anxiety and other measures were tested using Pearson correlation coefficients and to test the causal ralationship among the variables, regression analysis was performed. Results:The correlation coefficients between test anxiety and depression, state anxiety, trait anxiety were 0.56(p<0.05), 0.75(p<0.05), 0.53(p<0.05) respectively. The correlation coefficients between subscales of test anxiety and depression were all significant. The correlation between subscales of test anxiety and state and trait anxiety were also statistically significant. Conclusions:This study indicates that test anxiety is closely related with depression, state and trait anxiety. In addition, the subscales of test anxiety are significantly related with those of the depression. The correlation coefficients between test anxiety and state-trait anxiety are also statistically significant. Thus, in order to develop the preventive and effective methods for treatment, these psychopathological characteristics should be kept in mind.

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The Assessment of Ultrasensitive HBsAg kit's Sensitivity level and Performance in Detection of Mutant Forms (Ultra-sensitive HBsAg IRMA 키트의 민감도 및 변이형 검출능 평가)

  • Ha, Dong-Hyuk;Min, Kyung-Sun;Noh, Gyeong-Woon;Kim, Hyun-Ju
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.121-125
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    • 2011
  • Purpose: The DNA-type virus HBV, discovered by D. Dane and others in 1976, is approximately 42nm big and known as the main cause of liver-related diseases around the world. HBsAg has 4 kinds of subtypes including adw, adr, ayw and ayr and besides common antigen factor a, there are d, y, r, w. From the methods of serologically testing HBV, IRMA, EIA and CLIa were developed for testing HBsAg and are being used in examining the surface antigen of HBV. In this study, among the methods for testing HBV, the recently developed RIAKEY Ultrasensitive HBsAg IRMA kit's sensitivity level and performance in detection of mutant forms were measured and compared with CLIA. Materials and methods: Two certified reference materials, which are WHO 1st International Standard 1985(80/549) and WHO 2nd International Standard 2003(00/588. subtype adw2, genotypeA), were used in the examination and the sensitivity level was measured by diluting these materials from 0.08 IU/ml to 0.005 IU/ml. The materials for examining the detection of mutant forms included 9 kinds of subtype 'ad' and one kind of subtype 'ay' purchased from DSI company. Also, with the use of positive and negative samples, they was compared with CLIA. Result: Ultrasensitive HBsAg kit based on IRMA method showed the detection of up to 0.01 IU/ml not only for WHO 1st International Standard 1985(80/549) but also for WHO 2nd International Standard 2003(00/588. subtype adw2, genotypeA) and the sensitivity level was measured as 0.01 IU/ml by WHO standard. In testing the performance for detection of mutant forms, the 9 kinds of subtype 'ad' and one kind of subtype 'ay' mutant materials were detected, demonstrating the capacity of detecting various types of mutant forms. Conclusions: With the clinical importance of sensitivity level and performance in detection of mutant forms increasing in the field of HBsAg diagnosis, the examination of IRMA's effectiveness using RIA method in the aspects of the sensitivity level and performance in detection of mutant forms was carried out and its result is as follows. The sensitivity level was measured as 0.01 IU/ml by WHO standard and it was possible to measure various types of mutant forms with high sensitivity. Thus it is suggested that more speedy and accurate reports could be produced from a nuclear medicine laboratory for clinical practitioners requiring results of various situations.

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A Study of Design Process after Hospital Design Competitions - focused on the case study of current hospital design competitions - (병원건축 설계경기 후 설계진행에 관한 연구 - 최근 설계경기 사례를 중심으로 -)

  • Lee, Hae-Won;Lee, Jung-Man
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.7 no.2
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    • pp.47-58
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    • 2001
  • As one designs a building, one should have to consider its characters and functions according to its own use. Recently many professional buildings used to be designed by specialized design firms with their own experience and specialty to vitalize the functions of the buildings. Especially the design of the hospital is really needed more concern from the beginning of design ordering because it is pursuing the most specialty in architectural designs and therefore it can not be managed with general architects. The purpose of this study is to present the references for resonable promotions of hospital design in the future with the analysis of the suitability in hospital design ordering and the process after design competition in Korea.

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A STUDY ON THE STRUCTURAL RELATIONSHIP AMONG TEST ANXIETY, PSYCHOPATHOLOGY, TEMPERAMENT & FAMILY ENVIRONMENT (시험불안과 정신병리, 기질 그리고 가정환경 간의 구조적 관계에 관한 연구 - 시험불안-우울-불안-자기개념-가정환경간의 인과적 관계분석 -)

  • Cho, Soo-Churl;Yoo, Tae-Ik;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.50-63
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    • 1999
  • Introduction:Test anxiety is a pervasive problem among high school students in Korea. While anxiety in test situations may actually facilitate the performance of some students, more often it is disruptive and leads to performance decrements. Over the past years, many child psychiatrists have become concerned with understanding the nature of test anxiety, but it is not clearly understood yet. In order to understand the nature of test anxiety, the relationship between test anxiety and depression, state anxiety, trait anxiety, temperament and family environment were examined. Methods:The Test Anxiety Inventory, Chidlren's Depression Inventory, State-Trait Anxiety Inventory, Temperamnet and Family Environment Scale Scale were administered to 576 high school students in Seoul. The relationships between test anxiety and other measures were tested using Pearson correlation coefficients and to test the causal relationship among the variables, regression analysis was performed. Results:The correlation coefficients between test anxiety and depression, state anxiety, trait anxiety, temperament and family environment scale were 0.42(p<0.01), 0.34(p<0.05), 0.38(p<0.05), 0.36(p<0.05) and -0.23(p<0.01), respectively. Regression analysis showed that only state and trait anxiety had direct causal relationship with test anxiety. Depression, temperament and family environment were indirecly related with test anxiety. Conclusions:This study indicates that the level of state and trait anxiety are directly related with test anxiety, and other variables such as temperament, family environment and depression are indirectly related with test anxiety. Thus, in order to develop the effective methods for treatment, these psychopathological characteristics should be kept in mind and the most important factors are the levels of state and trait anxiety.

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Conflict Experience as an Occupational Therapist: Parse's Theory of Human Becoming (작업치료사로서의 갈등 경험에 관한 연구: Parse의 인간되어감 연구방법 적용)

  • Han, Sang-Woo;Ham, Bo-Hyun;Hong, Duk-Ki;Choi, Sung-Yul;Jeon, Byoung-Jin
    • The Journal of Korean society of community based occupational therapy
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    • v.4 no.1
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    • pp.47-58
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    • 2014
  • Objective : Commonly experienced as an occupational therapist to reveal the meaning of conflict, development by providing information on the quality of official development plan for therapists were willing to contribute. Method : In this study using Parse's human becoming method to collect and analyze data. Participants to understand purpose of the study's researchers and that can be spoken honestly their experience through dialogue were selected eight people as a clinical occupational therapist. Conversation period January-February 2012 was, at the time of about 30-40 minutes, Every conversation is more than three times for each participant were conducted. Result : Experience of occupational therapists, occupational therapy as a conflict of identity confusion and lack of awareness, feeling that comes from a poor working environment and social life, mental conflict, payroll issues to worry about, but concerns about the treatment of the future with hope and effort in the process was an experience. However, external, internal conflicts despite the uneasy reality academic experience for self-development and growth, and the development towards a positive future was out over it. Conclusion : Away from the internal and external conflicts therapists, occupational therapy and establish the identity of satisfaction and quality of care for the treatment to improve their physical and social environment, continuous improvement is necessary.

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DEVELOPMENTAL PSYCHOPHARMACOLOGY - DEVELOPMENTAL PHARMACOKINETICS, PHARMACODYNAMICS AND PHARMACOGENETICS - (발달학적 정신약물학 - 발달학적 약동학, 약역학 및 약물유전학 -)

  • Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.2
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    • pp.157-173
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    • 2003
  • The history of pediatric psychopharmacology is very short and the research on safety, efficacy and side effects is preliminary and long-term effect on growth and maturation is not well known yet. Clinical findings have shown that the responses to antidepressants, antipsychotics, CNS stimulants and steroids in children and adolescents might be different from adult populations. Based on these findings, this paper reviewed three issues, Firstly, in developmental pharmacokinetics. the author discussed the developmental factors affecting drug absorption, distribution, protein-binding, metabolism and excretion. Secondly, in developmental pharmacodynamics, developmental characteristics of dopamine, serotonin, norepinephrine receptors and their clinical implications were reviewed. Lastly, in pharamcogenetic part, the clinical utility of pharmacogenetics, pharmacokinetic aspects of pharmacogenetics, the pharmacodynamic aspects of pharmacogenetics, the association studies of dopamine-related alleles in neuropsychiatric disorders such as attention-deficit hyperactivity disorders or Tourette’s disorders, pharmacogenetic studies dopamine-related alleles and the pharmacogenetic studies of serotonin-related alleles. Based on these preliminary research, future pharmacogenetic applications in childhood and adolescent psychiatry were also discussed.

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Seven Cases of Severe Esophageal Stricture (고도의 식도 협착증 7 예)

  • 김기주;김호성;조중환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.5.2-5
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    • 1982
  • With the improvement of living standard and socioenvironmental change, esophageal stricture due to acetic acid, Hcl, insecticides and lye has led to decrease remarkably. Esophageal stricture has decreased because of immediate treatment and adequate management. However there are still sporadic incidents of esophageal stricture due to inadequate treatment and uncooperation of patients. The authors recently have experienced seven severe cases of esophageal stricture. All six patients were treated with 18-51 French Sippy esophageal dilating bougie. One patient was transfered to thoracic surgery department due to complete esophageal obstruction. Case 1. A 23 year old housewife who ingested Hcl for suicide. After Witzel's operation, she visited to dilate esophageal first constriction stircture due to swallowing difficulty postoperation 2 months later. We were treated successfully. Case 2. A case of esophageal stricuture in the second and third physiologic constriction part. The patient was 51 years old man who ingested lye accidently, and was dilated by bougination. Case 3. The patient was 43 year-old man who ingested acetic acid as a mistake and was treated inadequately at hopsital. Inspite of treatment, esophageal stricture developed at the third physiologic part. We are trying to dilate the esophagues now. Case 4. The patient was 55 year-old woman who had ingested Hcl for the purpose of suicidal attempt. 2 months later gastroduodenal anastomoisis due to pyloric region stenosis, the first physiologic constriction stricture was dilated successfully. Case 5. The patient was 41 year-old woman who ingested Hcl for suicide 4 months ago. There was indwelled orogastric tube for 1 month but esophageal stricture developed at the first and 3rd constriction part. She was treated by using a bougination. Case 6. An athlete 21 year old man, ingested acetic acid 2 spoonful per 3 days by purpose in order to soften the bone for last 14 months. There was complete esophageal obsturction in esophagogram and transferred to the thoracic surgery department. Case 7. A 3 year-old girl was ingested lye at a accident. She had a bougination for 16 months under the general anesthesia for dilation due to whole irregular esophageal stricture. She developed lower esophageal perforation, but healed eventually.

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A study on the gratification of the patient in the Dental Hospital (치과병원 내원환자의 만족도 조사분석)

  • Kim, Min-Young;Lee, Keun-Woo;Moon, Hong-Suk;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.65-82
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    • 2008
  • Statement of problem : Today's market economy has been changed more and more to consumer concerned. It is owing to not only consumers ' rising standard of living and education, but also purchasers' easy accessibilities to products through various mass media. The consumer centered market system, where customer can choose items with diverse alternatives to satisfy their self esteem, is also applied to the field of medical business, and accelerated by an increasing income level of shoppers and introducing the whole nations' medical insurance system. Today, the medical industry has become competitive due to increasing number of medical institutions and medical personnel, and this offers wide choices to consumers in the medical market place. At this point of time, it is essential to survey on the primary factor of gratification for the patient in the Dental clinic, as well as on the problems and suggestions in medical service. Purpose : The analysis in this study shows essential factors and expected influential elements in satisfaction of the patient in the Dental Hopsital, and strategic suggestions for the provider of dental service, which can be of benefit to the prospective customer as well as can make improvement in the quality of dental treatment service. Material and method : This study had been researched by collecting and analyzing the organized questionnaires, which were filled in directly from 784 patients, who visit Dental Hospital, Yonsei University in Seoul, from January 23rd to April 15th. Result : It can be summarized like the followings. 1. The social and demographical peculiarities of respondents are as follows. Samples of gender and marital status are adequately extracted, but data on occupation and treatment are are under a bias toward students, undergraduates and graduate students, and orthodontics. 2. 74% of patients who answer the questionnaire were highly satisfied with the service of dental clinic in the section of overall satisfaction. 3. The survey result about specific service of dental treatment, within sections of independent variables, is like the followings; Patients are highly gratified with service system, kindness, explanation, explanation on expected waiting hours, reservation system, emergency measures, expert treatment, existence of knowledge of dentistry, size of hospital, disinfection, equipment and parking, but lowly satisfied with expense of treatment, preparatory hours for treatment, waiting hours, treatment hours and the period of subscription. 4. The correlation analysis showed that there is no significant linear relationship between the independent variables. 5. The probit regression analysis showed that 8 out of 34 independent variables explained the dependent variables at the level of 0.01. 6. It shows that 8 independent variables, which can affect customers 'satisfaction, are clearing up of inconvenience, service system, kindness, explanation, treatment hours per attendance, reservation system, existence of knowledge of dentistry, and contentment of equipment in the hospital. Conclusion : The consumer's satisfaction totally relies on subjective evaluations of customers. Providing appropriate service, which can meet the criteria for the customer who demands various wares, pursues luxury goods, and expects high quality of medical service, is essential to fulfill patients' satisfaction. Many medical institutions do their best to satisfy their customer, touch their consumer, and offer patience centered services, and it is also applied to the field of dentistry. Establishing brand new strategic managements and elevating the quality of dental service based on this survey are required to improve the satisfaction of patience in the Dental Hospital.